The Pennine Acute Hospitals
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6 Endocrine system
06-01-02-03 Dipeptidylpeptidase-4 inhibitors (Gliptins)

Dipeptidylpeptidase-4 inhibitors (Gliptins)

Acute pancreatitis associated with gliptins has been reported. Inform patients of the symptoms of acute pancreatitis. If pancreatitis is suspected, the DPP-4 inhibitor should be discontinued.

• Only continue DPP-4 inhibitor therapy if the person has had a beneficial metabolic response (a reduction of at least 0.5 percentage points in HbA1c in 6 months) –as per NICE CG87.

• Monotherapy: Saxagliptin, Sitagliptin and Linagliptin – only if metformin contra-indicated or not tolerated. Alogliptin is not licensed for monotherapy.
• See individual SPCs for details of dosage in renal impairment.

GMMMG IPNTS: DPP-4 inhibitors (‘The Gliptins’) for the treatment of type 2 diabetes mellitus. Feb 2014


Alogliptin Vipidia®
First Choice
Tablets


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Linagliptin Trajenta®
Formulary
Tablets

note First choice 'Gliptin' for patients with moderate or severe renal impairment (CrCl<50ml/min, eGFR<59ml/min)

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Saxagliptin Onglyza®
Formulary
Tablets

note For established patients only. Alogliptin is first line.

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Sitagliptin Januvia®
Formulary
Tablets

note For established patients only. Alogliptin is first line.


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